Neuro Flashcards
What drug can be used to confirm a diagnosis of myasthenia gravis?
Edrophonium
ACh esterase Inhibitor
A positive Romberg test indicates a problem in?
Medial lemniscus (dorsal column) - carries proprioception, vibration, light touch Problem with proprioception or vestibular apparatus, sensory deficits
Age related hearing loss is caused by degeneration of?
the proximal hair cells of the organ of Corti
Presbyacusis
harder to hear high pitched voices
A pt with daytime sleepines and decreased sleep time and decreased REM sleep time. Which neurotransmitter is responsible for the decrease in the patient’s REM sleep?
Decreased ACh
ACh induces REM and normal aging is associated with a decrease in ACh.
Older Pt with proximal muscle weakness (difficulty walking up stairs or rising from a chair), delayed relaxation of muscles (slow to unclench a fist), notes that mom had a similar condition
Myotonic dystrophy type 2
nucleotide repeat expansion (CCTG) withing the CNBP gene
Type 1 presents in childhood
What test can be used to confirm a dx of Parkinson?
Clinical response to Dopamine
Microglia are differentiate from which germinal tissue?
Mesoderm. Differentiate from blood monocytes (think of microglia as CNS macrophages)
A pt presents with hoarseness following a thyroidectomy. Which pharyngeal arch is the origin of this nerve?
Branchial arch 6
recurrent laryngeal n. (Branch of X) inn the muscles of the larynx
Following a surgery a pt has difficulty swallowing and absence of gag reflex. Which pharyngeal arch was damaged?
Brnachial arch 4
Superior laryngeal inn paryngeal constrictors, cricothyroid, levator veli palatini
A child presents with a large abdominal mass, HTN, dark circles under the eyes, elevated urine catecholamine. Bx of the mass reveals small round cells with hyperchromatic nuclei forming a pseudorosette pattern around central primative nerve fibers
Neuroblastoma
Most common tumor of the adrenal gland in children
Also most common malignant solid tumor outside of the cranium in children
Caused by amplification of N-myc (protooncogene)
A study that follow subjects without a disease who are then randomized into different levels of exposure to a risk factor and monitored for development of dz is what type of study?
Prospective cohort
Parkinsons dz is caused by degeneration of?
Dopamine producing neurons in the substantia nigra
A pt with a herniated disc at the L5-S1 level will likely have weakness in which reflex?
Compressed S1
Diminished ankle-jerk reflex
A pt with right sided loss of coordination (ataxia), hypotonia, intention tremor, and instability (pt feels like they will fall). Difficulty with finger to nose test on right side. Where is the lesion?
Right cerebellar hemisphere
Cerebellar lesions are ipsilateral
A pt with classic bell palsy where the whole half of his face is paralyzed
Lower moto lesion CN VII
If it was upper motor her would be able to move his eyebrows
During preparation for surgery a pt is confused, tachycardic, tachypneic, and hypertensive. Skin is dry, flushed, warm to the touch with fixed dilated pupils. Pt has been overdosed on?
Atropine
Nonselective muscarining antagonist used in surgery to suppress bronchial secretions
Correct with physostigmine
alpha synuclein deposits is associated with?
Parkinson dz
alpha synuclein = Lewy bodies
A pt presents with uncontrolled DM and diplopia. Right eyelid is drooping and eye is abducted and depressed. Which EOM is still functioning?
Lateral rectus (CN VI) Superior oblique (CN IV) Pt has CN III palsy due to DM neuropathy (inf med and sup rectus, inf oblique)
What is an abortive therapy that is used in a pt with repeat cluster HA?
Oxygen inhalation therapy
Following surgery a pt has lost bilateral motor, pain, and sensation below dermatome T6.
Vibration, light touch, and position sense are intact. What happened?
Hypoperfusion of the anterior spinal a.
Sole vessel that feeds the ventral 2/3 of the spinal cord
artery of adamkiewicz feeds the lower spinal cord (T8-L4)
What is the function of the nodes of Ranvier?
Sites of inward current
Facilitates saltatory conduction
In order to cure Shingles, the drug would have to penetrate the?
Perineurium
This is the tissue that surrounds fascicles of nerve fibers and serves at the permeability barrier in the nervous system
A pt states that his legs violently shakes when he walks and that his dad and uncle had similar symtpoms. On PE the muscles of the leg are held in spasm. Dx and where is the lesion?
Spastic paraplegia AKA hereditary spastic paraplegia
Lesion in the corticospinal tract.
Which tract controls the descending voluntary movements of contralateral limbs?
Lateral corticospinal tract
Legs are Lateral